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On the 13th of May the Health and Social Services Department (HSSD) published a report into children’s services that contained a number of inaccuracies. As this report was published without consultation with previous members of the board of HSSD and no attempt was made to verify its assertions prior to publication, I feel that the department have lied about my time on the board and have called into question the action of civil servants who do not have the opportunity to publicly refute the claims.

Given the failings in the report I feel it appropriate to publicly publish my email sent to Deputy Luxon and the full board of HSSD seeking correction and clarification for their action.

Dear Paul,

I know that other members of the previous HSSD board have contacted you in relation to the blatant and damaging errors contained in the recently published report concerning Children’s Services, but feel that I must add my voice to the utter dismay as to the failings of this report and my consequent skepticism and lack of confidence in the whole report. This is highly regrettable as I believe there to be a number of areas within the HSSD Children’s Service that need addressing. The service was repeatedly the highest risk item on the department’s risk register and as such, received close attention for the whole time that I served on the board, I’m please to note that the new board is also taking this area seriously, but have little faith in this report due to the fabrication and lies that I’m able to so easily identify. Questions therefore are naturally raised as to the quality and value of the remainder of the report. This only works to undermine any findings and calls into question what the department intends to do to verify the report. Were I to be completely cynical, and it’s difficult not to be, I have to question whether the report writer has undertaken a review with findings that ensures her continued employment, as is so often the case with consultants. I sincerely hope that such cynicism will be proved incorrect, but given the questions that I outline below, I’m sure you’ll understand why I come to such a position.

the report states that “Using that criteria, the service would be judged inadequate, due to the inability to evidence clear governance, the lack of outcomes measures and performance data……” Indicating what I stated clearly in the SCIP debate concerning the lack of information linked to the inadequate Child Information Database. I strongly opposed the delay in implementing this replacement system proposed in an amendment laid by Deputy Soulsby and seconded by Deputy Le Clerc to the SCIP report, I am now left wondering whether the delay in implementation has happened inadvertently by the proposer of that amendment being made chair of the very committee charged with implementing this software. Could I therefore have an assurance that the swift implementation of the Child Information Database replacement remains the main priority of the Electronic Health and Social Care Record board? How is it that the system is still in the procurement phase when the SCIP report, approved by the States in July 2014, released the funding?

The report states “there is no evidence that the States takes seriously its responsibilities for corporate parenting of children in care.”. Anyone taking a cursory glance at the board meeting minutes, whenever corporate parenting was discussed, will note how seriously they were dealt with by all concerned and discussed at length. I’m sure that previous boards also took this responsibility seriously, did the report writer not have access to board minutes pertaining to corporate parenting and if not, why not? If so, how can we believe that this document is evidence based when it has ignored that very evidence?

The report states there is “…..low investment in training local people into social work……..”. I was advised, repeatedly, that the real difficulty in training local people in Social Work on island was due to a lack of placements. For every placement that was possible, I was advised that the position was filled. Why has the report made no mention of the lack of possible placements as an issue but has rather focused solely on cost?

The report states “ A high proportion of cases in the Assessment and Intervention Team (AIT) are subject to strategy meetings as a means of ensuring that information is shared, although less than half result in a joint investigation1.” But the superscript 1 refers to the caveat “1 Data based on my own research for the diagnostic as none was available”. With no data available, how can such an assertion be made?

The report states “The senior leadership team for CSC has been seriously undermined by a lack of engagement from the previous Chief Officer and the former HSSD Board.” This is complete false nonsense. Both previous boards made visits to various parts of the HSSD estate and spent considerable time discussing issues with staff on these visits. From memory I believe there was a board meeting held at Perruque House whilst Deputy Adam was minister with a visit to the services there immediately after the board meeting. Whilst Deputy Dorey was minister I remember an extended visit to both Perruque House and the Carrefour, that same day we were expected to visit Swissville, but due to the amount of discussions and time we spent at Perruque and Carrefour we had to delay the visit to Swissville. When we did visit Swissville, this was an extensive visit with plenty of opportunity for discussion between board members and staff. I also distinctly remember visiting Lukis House with Deputy James who should be able to correct the misinformation contained in this report. Both boards also held frequent meetings with senior staff of Children’s service. I have to ask what the current board were thinking when they authorised the publication of this report with this statement? It is evident that I personally arranged a presentation for all deputies prior to the States Capital Investment Programme (SCIP) debate since we were seeking funding for the replacement Child Information Database (CID) system, did the board think that I would arrange such a presentation without discussing the issues thoroughly with the staff at children’s services? Did the board think that we would seek funding without understanding the risks currently carried by Children’s services as a result of the inadequacy of that computer system? Did the board think that we would pursue an extension to the CYPP without first having an in-depth discussions as to the merits of such actions, as opposed to the alternative of implementing the draft that was presented to us? I’m aghast as to the board’s thinking on publishing such a statement, or was it the case that the board simply didn’t read the report? Was no consideration given to the quality of the work and the appropriateness of its content? Or did the board take all the content at face value? What has the current chief officer done to rectify this blatant fabrication and what role did the chief officer have in quality assurance of the report writer and the quality of the content of the report? I’m sure in time I’ll have further questions on this aspect as it’s the one part that I’m fully able to evidence to the contrary, but for the time being, a frank and honest response is urgently required and a public apology from the report writer, board and chief officer is also expected.

The report states “Managers have been clear that there was a culture where problems and issues were not to be escalated and no performance data, other than the financial risks outlined in the Governance reports was to be shared with the Board”. Anecdotally I’ve noted the agenda items for the board meeting 15th October 2014 when a governance report from the Children & Maternity service was tabled. I distinctly remember questioning the lack of content of these reports and how it would be necessary to extend the content to include outcomes and quality measurements, this was whilst the current chief officer was sat at the table. Anecdotally, further to this, I distinctly remember being advised by senior staff at HSSD how reports concerning the work, quality assurance and outcomes of other parts of the HSSD were not tabled at the board meeting due to the current Chief Officer active blocking of these reports from being progressed above the Corporate Management Team (CMT). Can the board therefore state what actions they’re taking to ensure that such reports are now tabled at the board meeting and not blocked at CMT level?

The report states “….. staff and managers have had to develop their own systems and approaches, drawing on what they each believe to be good practice, rather than on what the HSSD aspires to on behalf of the population that it serves.”. Could I ask whether the governance and assurance team have been consulted on the content of this report as I believed they were actively working with the Children’s Services to agree measurements that were to be reported regularly to the board.

The report states “the care offered by the residential home, Le Carrefour, is positive and well-managed, with regular meetings with young residents who are able to inform the way in which the unit is run. However, there is an appalling lack of investment in the physical fabric of the building, the transport, and in the training and development of the staff who run it, and no Board member or Chief Officer, prior to the current CO and Board, has ever visited this service”. I distinctly remember two visits to Le Carrefour whilst on the board, one of which to the residential part had to be aborted as the children who were resident were in the building at the time. I’m sure you’d agree that a visit at such a time, when specifically requested by the children resident not to have a visit from the board, would be inappropriate. On that occasion we proceeded to the secure unit part of the Carrefour only. On the second occasion the visit was extensive with a thorough discussion held between deputies and the staff running Le Carrefour and a full visit to the site was possible. It was recognised that the fabric of Le Carrefour was inadequate and a decision by the board to lease two new residential homes was made to rectify the situation for future children taken into care. A visit to these new properties as well as a number of other properties used by Children’s Services was part of the board’s rolling programme of visiting all premises forming part of the HSSD estate. All visits to the properties used by children’s services included conversations and consultations with the staff working in those locations. I’d also like to highlight how the new phase 6B development includes a secure unit to replace that at Le Carrefour.

The report states in its recommendations “Immediately: Agree how the findings of this review are to be shared with staff who participated, and their views reflected where there are any disagreements with the evidence base or findings.” Evidently the report has failed on the first hurdle given that those deputies mentioned have evidenced how wrong the report’s assertions are, could I ask whether there has been a peer review of the paper by all other staff members? Who else disagrees with the report’s assertions and what is the board doing to rectify these blatant and damaging failings?

I’m still working my way through the detailed findings and will no doubt have other questions on that section, but in the interim I have these further observations on the first part of the report.

Given that the report includes such blatant lies about my conduct and time on the board of HSSD, why should I believe any other part of the report? Given these inaccuracies and down right lies, may I ask how much money was spent on the production of this report as well as how much time senior staff spent in its production and an estimated cost of their time? What peer review has been done of the report? What do the board intend to do to verify what is accurate and what else is false?

A previous report looking at the Children and Young People’s Plan was conducted by another consultant who made some review and observation of the children’s services, what has the board done in relation to those findings prior to commissioning this further report? Are we to have endless reports highlighting the problems but dealing with none?

Given the public way that the report has besmirched my name and that of all other deputies that served on the board of HSSD, I’m sure you’ll understand that I’ve published these points and ensured public circulation. I expect a swift and public apology from the department for their action and an answer to the questions above if the report is to have any credibility.

I’m sure that my anger as to this unacceptable publication is evident. I fail to understand what the report writer, chief officer or board thought they would achieve in attacking former chief officers and board members. I’m fortunate that I can publicly refute the lies included in the report, such a public platform is not afforded to the civil servants that the report made such damming attacks against, therefore I would expect the department to be issuing an apology to those civil servants as well.

I’d hoped not to enter into a public discussion on HSSD for the rest of my term as I feared that I could be viewed as being bitter, but I did not expect an attack that would justify such bitterness.

Yours in disgust and annoyance,

Elis Bebb

I await their response which I expect to be public.

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This week is Dying Matters Awareness Week, starting on the 12th May until the 18th, it aims to get people talking about death and encourages us to make provision for one of the certainties in life, its end.

As with many of these campaign weeks, the national media have been running stories to coincide with the events and I was personally surprised to read the following story on the bbc website showing that so few of us have made arrangements concerning our end of life. The details are there for anyone to read, but if I simply restate here that only 21% of respondents to a survey state that they’ve discussed their end of life arrangements, I think the problem becomes clear given that 100% will die.

Here in Guernsey there’s a wonderful campaign underway this week with the pop up shop in Smith Street taken over for the campaign and the arts commission have installed a Before I Die…. wall in the market. All geared to get people talking about, and making, end of life arrangements.

I’ve never quite felt comfortable about the term “end of life” as I always thought it was a nice way of saying “death”, but I’ve now come to realise that it’s about a lot more than the final act of death. Dying, for many people, is a process that takes time and what the campaign is asking of us is not simply to arrange our funeral and write a will, important though they might be, but to also discuss our long term care should we become incapable of making those decisions ourselves.

In the UK people may choose to write what is colloquially known as a living will, or if you’ve been watching a little too much American drama, an advance directive. This is particularly timely, as the States will be discussing a requête by Deputy Perrot (turn to page 193) when we’re finished debating the transport strategy. The requête seeks the introduction of an Enduring Power of Attorney, the ability to decide in advance of losing capacity what arrangements you’d like to put in place for that day, should it happen. This is only a small part of what is required in terms of capacity legislation, but will assist many people in determining their health care requirements in advance of losing the capacity to do so. The obvious beneficiaries will be those who go on to develop dementia, or those that suffer enduring mental health conditions that cause them to lose capacity for short periods of time.

I’m very supportive of the requête and will vote accordingly, my hope being that people will complete an Enduring Power of Attorney at the same time that they write a will, or to have the opportunity of writing one when they’ve first been diagnosed with some form of dementia. It’s important that we afford people the choice of deciding their future care needs.

An Enduring Power of Attorney would also assist HSSD in their care of people. I’m sure it will come as no surprise, now you know there’s no advanced directive available in law here, that certain care decisions become difficult for the professional carers. Doctors, nurses and social workers can find themselves in the eye of a family feud with no basis in law to fulfil what is the patient’s wishes. This is a situation we surely can’t allow to continue.
I sincerely hope the requête will be successful and the law introduced swiftly.

On a personal note, I’m surprised people don’t talk about dying. It may be me or it may be a Welsh thing, but death is not a difficult discussion around the dinner table with the family. Well maybe not the dinner table, but I was back in Wales a couple of weeks ago and I had an evening meal with my sister and her family. After dinner the discussion moved at one point to our choices of hymns for our funerals and where we’d like to be buried. It wasn’t a depressing conversation, it was rather affirming to have such a discussion and understand why we’d both chosen our respective burial plots. It was interesting how we’d both moved from being in favour of cremation to burial. We had a good laugh about our choice of hymn and her incredulity as to how catholic I was compared to her protestant position. It was a fun evening with plenty of laughter and shows that difficult conversations can be had whilst enjoying yourself.

Having written all the above, I suppose I should also confess to being someone who hasn’t yet written a will, something that’s particularly important given that I’m in a long term relationship and haven’t married. I haven’t made proper arrangements to be an organ donor. I therefore pledge to deal with these issues this week. Hopefully a number of people will do the same, after all, if not this week, when?

The one thing we can all be sure of is dying. All of us probably know of a family that have torn themselves apart over a lack of a will. All of us probably know someone who’s had, or is currently suffering dementia, do we know if they’re receiving the care they would have wished? If you’ve attended as many funerals as I have you’ll also have seen exactly what you don’t want for your funeral and maybe some things that you do want.

Can I suggest that you give yourself a gift of ensuring you have a voice in your long term care and funeral arrangements. I’m arranging mine this week.

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So why Blog? Isn’t it enough that the political world of a small island is sufficiently covered by the excellent coverage of the BBC, Channel News and the omnipresent Guernsey Press? Virtually every day we have another news story concerning deputies that appears in the pages of the Guernsey Press or over the airwaves on BBC Radio Guernsey; add that to the endless rounds of government consultations, presentations, the monthly meeting of the State’s of Deliberation and we have as much political discourse as you’d need on an island of sixty thousand odd inhabitants (I know that the last number will be considered contentious by some of you due to a recent debate) isn’t it?

Well maybe not. I mean no disrespect to anyone when I say that I find the Guernsey Press is most extensive in its coverage but has its own agenda that it pushes; BBC Radio Guernsey are a little on the timid side not wanting to enter into a political discussion, hence the incredibly weak format of the Sunday Phone In where all political questions are passed over to the public; and Channel TV that only have a half hour slot every day to cover events on all of the islands (who cares what’s happening in Jersey?).

Given that I’m not known for being a timid wall flower (well I don’t think so anyway) and given that I get rather frustrated with people’s view of the political discussions I thought it time to start presenting my view in the round rather than the narrow view that’s so frequently presented in the conventional media. I frequently talk to people on Twitter (yes please follow me on @elisbebb) and discover that a subject that has raised passions hasn’t been well explained. We lack the PR machinery that is ever present in other jurisdictions (thank the Lord) that seek to give flesh on the bones of an argument.

There is also, I suppose, a selfish view that if I blog successfully I may not be subject to quite so many questions or (on a less frequent basis) attacks for my position. But then that may be considered altruistic rather than selfish.

Finally, yes I will consider writing a political blog on requests that I receive but no, I don’t guarantee that I will and no, I won’t necessarily agree with everyone.